Clinical Utility of Serum Neuropeptide Q in Patients With Acute Coronary Syndrome: A Case-Control Observational Pilot Study

Objective: Current cardiac biomarkers lack specificity and are limited by instrumental constraints in diagnosing acute coronary syndrome (ACS).Therefore, research has focused on identifying new cardiac biomarkers, e.g., neuropeptide Q (NPQ), associated with the pathophysiological response to myocardial injury.NPQ plays an important role in metabolic regulation and cardiac protection.As there are limited studies on the role of NPQ in ACS, we assessed serum NPQ levels in ACS patients and healthy populations to evaluate serum NPQ's clinical utility in ACS.Materials and methods: We recruited ACS patients (n = 120) and non-hospitalized healthy participants (n = 40).The baseline characteristics and history were recorded.Biochemical investigations, including serum NPQ and heart-type fatty acid-binding protein (H-FABP), were measured using blood samples collected at a mean of 24 hours after the onset of chest pain in ACS patients and at the time of enrolment of healthy participants.Appropriate statistical tests were performed.Results: ACS patients had significantly higher serum NPQ and H-FABP levels as compared to healthy participants.Serum NPQ levels showed a significant positive correlation with weight, waist circumference, creatine kinase-total, creatine kinase-MB, and H-FABP levels and showed a significant negative correlation with white blood cells (WBCs) and serum high-density lipoprotein-cholesterol (HDL-C) levels.In univariate logistic regression, weight, WBC, HDL-C, and NPQ levels were linked with ACS outcome in study participants.In multivariate logistic regression analysis, after adjusting for potential confounders, WBC and NPQ were independently linked with ACS outcome in the study population.Receiver operating characteristic curve evaluation showed that the cut-off value of serum NPQ level for prediction of ACS was 2.53 ng/mL, with a specificity of 67.5%, sensitivity of 71%, and an area under the curve of 0.808 (95% CI: 0.731-0.886).Conclusion: The study showed that the reported performance characteristics of serum NPQ levels strictly differentiate between established ACS patients and apparently healthy participants.Its diagnostic utility when facing a standard chest-pain differential diagnosis remains completely unknown.However, our findings should be confirmed by further studies.